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Dupuytren disease
Other Resources UpToDate PubMed

Dupuytren disease

Contributors: Trevor Hansen MD, Laurie Good MD, Danielle Wilbur MD
Other Resources UpToDate PubMed


Causes / typical injury mechanism: Dupuytren disease is a fibroproliferative condition involving the palmar aponeurosis.

Classic history and presentation: Initial symptoms include thickened nodules or plaques (grade 1), which are followed by fibrous band development (grade 2). With progression and increased fibrosis, flexion contractures develop as bands cross the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints (grade 3). Patients may also present with similar findings in the plantar fascia (Ledderhose disease). Presentation can be unilateral or bilateral, with one hand typically being more severe than the other.

  • Age of onset – Fifth decade of life in men, sixth to seventh decade of life in women.
  • Sex / gender – White men of Northern or Eastern European descent are most commonly affected. 2:1 male predominance.
Risk factors: Risk factors include alcohol use disorder, tobacco use, and certain family history; evidence supports an autosomal dominant pattern of inheritance. A 2011 study identified 9 loci associated with genetic susceptibility to Dupuytren disease; 6 of the loci contain genes that encode proteins in the Wnt-signaling pathway, and the authors postulate that aberrations in this signaling pathway are related to the process of fibromatosis in the disease.

A small portion of patients with Dupuytren disease also develop Peyronie disease.

Pediatric patient considerations: Rarely the condition can present in pediatric patients, although the clinician should be mindful of epithelioid sarcoma.

Pathophysiology: At present, the pathophysiology of the disorder is not entirely understood, although several factors are believed to contribute to fibroblastic proliferation and altered collagen profiles, including specific platelet-derived fibroblast growth and transforming growth factors.


M72.0 – Palmar fascial fibromatosis [Dupuytren]

410812005 – Dupuytren's disease

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Volkmann ischemic contracture
  • Diabetic cheiroarthropathy
  • Trigger finger
  • Other fibromatoses
Pediatric patient considerations:
  • Epithelioid sarcoma

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:09/17/2020
Last Updated:01/13/2022
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Dupuytren disease
Clinical image of Dupuytren disease - imageId=5311536. Click to open in gallery.  caption: 'A horizontal depression flanked by fibrotic bands on the palm.'
A horizontal depression flanked by fibrotic bands on the palm.
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